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Background and Objective: Given the potential association between oxidative stress, periodontitis and dental caries, whether dietary supplementation with antioxidants is beneficial for periodontitis and dental caries has been widely reported, but remains controversial. This study aims to clarify these relationships through two‐sample Mendelian randomization (MR) analysis. Methods: Circulating antioxidants (copper, selenium, zinc, ascorbate, β‐carotene, lycopene, retinol and vitamin E) were derived from absolute circulating antioxidants and circulating antioxidant metabolites. Summary data of periodontitis and dental caries were obtained from two separate databases, respectively. We performed inverse‐variance weighted (IVW) analysis separately in different databases, followed by meta‐analysis. The robustness of results was examined by sensitivity analyses, including three complementary MR methods, heterogeneity and pleiotropy tests, and PhenoScanner query. Results: IVW analysis showed that elevated levels of absolute circulating retinol reduced the risk of periodontitis (GLIDE: OR = 0.41, 95% CI = 0.18–0.95, p =.038, power = 100%; FinnGen: OR = 0.15, 95% CI = 0.04–0.54, p =.004, power = 100%). The pooled OR for periodontitis risk per unit increase of retinol is 0.30 (95% CI = 0.15–0.61, p =.001, I2 = 40.3%, power = 100%). No significant associations were noted for genetically predicted circulating antioxidants and dental caries risk. The sensitivity analyses yielded similar estimates. Conclusion: This study demonstrates that a negative causality between circulating retinol and periodontitis risk, and null linkage between circulating antioxidants and dental caries risk, suggesting potential strategies for the prevention and control of periodontitis. [ABSTRACT FROM AUTHOR]

Over the last two decades, great efforts and investments have been made in Ethiopia to ensure that all children have equal access to nutrition services in health facilities. While quality health systems are a prerequisite for quality nutrition services, little attention has been given to the evaluation of the supply and delivery services. The purpose of the study was to evaluate the coverage and quality of the nutrition‐specific interventions delivered through the health system. Using an end‐user monitoring (EUM) system, we monitored the delivery of nutrition‐specific interventions in 500 districts, having 2514 health facilities distributed throughout Ethiopia. Data were collected through third‐party monitors between August 2020 and 2021. Roughly 90% of health facilities were performing severe acute malnutrition management in line with the national guideline/protocol, and 2/3 of the assessed facilities were delivering iron and folic acid, vitamin A supplementation and deworming. A third of the messages on AMIYCN were retained by beneficiaries. Warehouse conditions were good in 64.3% of the facilities, but only 22% had good recording practices and about half had problems related to the quality and availability of nutrition supplies. Most beneficiaries were satisfied with the nutrition supplies and service delivered at the health facility level. This study also suggests the relevance of an EUM system to assess the quality of nutrition service delivery and its related supply management, as well as to improve the implementation of nutrition interventions as a decision‐making tool. Key messages: The main bottleneck identified in supply management was the recording system, while roughly 65% of warehouses are in good condition to store nutrition supplies at the health facility level.Roughly 90% of health facilities were performing severe acute malnutrition management in line with the national guideline, while 2/3 of the health facilities are delivering iron and folic acid, vitamin A supplementation and deworming.The knowledge and practices of the HW were above average and only a third of the messages delivered were retained by beneficiariesAlthough messages are being well delivered once counselling is implemented, many opportunities (contact points) are missed to deliver nutrition counselling. [ABSTRACT FROM AUTHOR]

Topical retinoids continue to be the treatment of choice for healthcare professionals and patients due to their effectiveness in treating several common skincare concerns. In a comprehensive review, Cigdem Kemal Yilmaz discusses the most used topical retinoids: retinyl palmitate, retinol, retinal (retinaldehyde), tretinoin (retinoic acid) and adapalene, and their potential benefits to the skin. This article also addresses the latest EU regulations impacting their use, and the necessity for healthcare professionals to stay informed about advancements and regulatory changes in topical retinoid therapy in order to provide personalised treatment plans for their patients. [ABSTRACT FROM AUTHOR]

Longitudinal bone growth is mediated through several mechanisms including macro- and micronutrients, and endocrine and paracrine hormones. These mechanisms can be affected by childhood obesity as excess adiposity may affect signaling pathways, place undue stress on the body, and affect normal physiology. This review describes the physiology of the epiphyseal growth plate, its regulation under healthy weight and obesity parameters, and bone pathology following obesity. A literature review was performed utilizing PubMed, PMC, NIH, and the Cochrane Database of Systematic Reviews pertinent to hormonal and nutritional effects on bone development, child obesity, and pathologic bone development related to weight. The review indicates a complex network of nutrients, hormones, and multi-system interactions mediates long bone growth. As growth of long bones occurs during childhood and the pubertal growth spurt, pediatric bones require adequate levels of minerals, vitamins, amino acids, and a base caloric supply for energy. Recommendations should focus on a nutrient-dense dietary approach rather than restrictive caloric diets to maintain optimal health. In conclusion, childhood obesity has profound multifaceted effects on the developing musculoskeletal system, ultimately causing poor nutritional status during development. Weight loss, under medical supervision, with proper nutritional guidelines, can help counteract the ill effects of childhood obesity. [ABSTRACT FROM AUTHOR]

We searched PubMed, Web of Science, Embase, The Cochrane Library, China Biomedical Literature Database and other databases from inception to June 2023. The included studies were randomised controlled trials (RCT). The studies were screened by four authors, divided into two independent pairs. A total of eighteen studies were included, including 1362 patients, involving twelve intervention measures. The different nutrients had a significant effect on improving blood glucose, reducing inflammation levels and reducing oxidative stress compared with placebo (P < 0.05). Cumulative probability ranking showed that vitamin A + vitamin D + vitamin E ranked first in lowering fasting blood glucose (standardised mean difference (SMD) = 41.30, 95 % CI (2.07, 825.60)) and postprandial 2-h blood glucose (SMD = 15.19, 95 % CI (4.16, 55.53)). In terms of insulin resistance index, the first highest probability ranking is vitamin D (SMD = 5.12, 95 % CI (0.76, 34.54)). In terms of reducing the high-sensitivity C-reactive protein level, the first in probability ranking is VE (SMD = 2.58, 95 % CI (1.87,3.55)). The results of cumulative probability ranking showed that Mg + Zn + Ca + VD ranked first in reducing TNF-α (SMD = 1.90, 95% CI (0.40, 9.08)) and IL-6 (SMD = 1.83, 95 % CI (0.37, 9.12)). In terms of reducing malondialdehyde levels, the first ranked probability is VB1 (SMD = 4.99, 95 % CI (1.85, 13.46)). Cumulative probability ranking results showed that Ca + VD ranked first in reducing total antioxidant capacity (SMD = 0.66,95 % CI (0.38, 1.15)) and glutathione (SMD = 1.39, 95 % CI (0.43, 4.56)). In conclusion, nutritional interventions have significant effects on improving blood glucose, inflammatory levels and oxidative stress in patients with gestational diabetes. Due to the high uncertainty in the results and differences in the number and quality of studies included, the reliability of the conclusions still needs to be validated by conducting large-sample, high-quality RCT studies. [ABSTRACT FROM AUTHOR]

Since the establishment of a clear link between maternal alcohol consumption during pregnancy and certain birth defects, the research into the treatment of FASD has become increasingly sophisticated. The field has begun to explore the possibility of intervening at different levels, and animal studies have provided valuable insights into the pathophysiology of the disease, forming the basis for implementing potential therapies with increasingly precise mechanisms. The recent reports suggest that compounds that reduce the severity of neurodevelopmental deficits, including glial cell function and myelination, and/or target oxidative stress and inflammation may be effective in treating FASD. Our goal in writing this article was to analyze and synthesize current experimental therapeutic interventions for FASD, elucidating their potential mechanisms of action, translational relevance, and implications for clinical application. This review exclusively focuses on animal models and the interventions used in these models to outline the current direction of research. We conclude that given the complexity of the underlying mechanisms, a multifactorial approach combining nutritional supplementation, pharmacotherapy, and behavioral techniques tailored to the stage and severity of the disease may be a promising avenue for further research in humans. [ABSTRACT FROM AUTHOR]

Vitamin A supplementation (VAS) can protect children from the adverse health consequences of vitamin A deficiency. Granular data on VAS coverage can guide global and national efforts to achieve universal VAS coverage. To provide geographically precise targeting of VAS programs and to monitor progress in reducing geographic disparities, we aimed to create high-resolution (5 × 5 km2) maps of VAS coverage in children under 5 years across VAS priority countries. We used cross-sectional data from the Demographic and Health Surveys (DHS) program. We used data from the DHS program for United Nations Children's Fund –designated VAS priority countries between 2000 and 2017 with data available from 2005 or later. The outcome variable was the proportion of children under 5 years who received a vitamin A dose in each sampled cluster. We applied a Bayesian geostatistical approach incorporating geographic, climatic, and nutritional covariates to estimate VAS coverage for each cell. We estimated and mapped absolute VAS coverage, Bayesian uncertainty intervals, and exceedance probabilities. Our sample included countries from Latin America and the Caribbean, Asia, and Africa. Most countries had estimated VAS coverage levels <70%, and our exceedance probabilities indicated high certainty that our estimates fell below this threshold in most grid cells. International variations were most notable in the Latin America and the Caribbean region and Africa. Intranational variations were greatest in some South Asian and West and Central African countries. These prevalence and exceedance maps, especially used with data on indicators of VAS need, could help to improve equity. [ABSTRACT FROM AUTHOR]

Objectives: In Africa and Asia, 190 million preschoolers are vitamin A deficient. This study examined the social determinants of intake of vitamin A supplementation (VAS) among children aged 6–59 months during three different time periods in Kenya to identify those most vulnerable to vitamin A deficiency and highlight the varied targeting and outreach efforts; before the onset of a national restructuring and targeted distribution of VAS in children below 5 years through a twice-yearly door-to-door campaign called Child Health Weeks, during the implementation period, and several years later. Methods: The cross-sectional, national Demographic and Health Surveys were administered in Kenya in 2003, 2008-09, and 2014. Bivariate and multivariable logistic regression analyses were used to assess variables associated with VAS among children (n = 28,239). Results: An overall two-fold increase in VAS was recorded between 2003 (31.8%) and 2014 (67.5%). In 2008-09, children aged 6–11 months were the most likely to receive VAS. In 2003 and 2014, geographical regions and settings, birth order of the child, educational level of the mother, religion, wealth index, number of antenatal visits, and access to a radio were identified as being significantly associated with VAS, in at least one of the years. These determinants were not significant in 2008-09 during the initial Child Health Weeks promotion campaign. The determinants of VAS varied during the three study periods, particularly in 2008-09 when the Child Health Weeks was first implemented. Conclusion: As efforts to increase VAS continue, addressing child-specific determinants will be essential to reduce health disparities. Significance: Childhood vitamin A deficiency has been identified as one of the public health priorities in Kenyan children below 5 years that causes severe malnutrition. The importance of VAS was identified as a cost-effective strategy of combating and eradicating childhood malnutrition based on a previous national micronutrient survey. However, Kenya's VAS inequities are exacerbated by the social and economic differences of women. The WHO defines these disproportionate differences as the social determinants of health. Identifying these factors will be influential for policy makers to make targeted efforts towards increasing VAS supplementation and contribution towards reducing child mortality. [ABSTRACT FROM AUTHOR]

Vitamin A is a fat-soluble micronutrient vital for the immune system, cellular differentiation, epithelial barrier function, and eyesight; they also play a significant function as a potent antioxidant regulating oxidative stress and the onset of cancer. There are two ways to get it through food: Provitamin A (beta-carotenoid) and preformed Vitamin A (retinol and retinyl ester). Uncontrolled cell proliferation and the development of metastatic features are characteristics of cancer initiated by agents such as aflatoxin, tobacco smoke's carcinogenic compounds, and solar ultraviolet radiation. Vitamin A, an antioxidant vitamin, is hypothesized to exert chemo-preventive effects and reduce the risk of cancer by preventing tissue damage through the capture of organic free radicals, an end-product of numerous metabolic processes. This review is performed to investigate the association between Vitamin A and cancer. From March 2017 to March 2022, relevant articles were searched through PubMed, Science Direct, and Google Scholar databases. All the studies involving Vitamin A and cancer were included in this review. Intake of Vitamin A was significantly inversely associated with improved cancer prognosis. The present review demonstrates that there is an inverse association between Vitamin A and cancer treatment. [ABSTRACT FROM AUTHOR]

Suboptimal status of folate and/or interrelated B vitamins (B12, B6 and riboflavin) can perturb one‐carbon metabolism and adversely affect brain development in early life and brain function in later life. Human studies show that maternal folate status during pregnancy is associated with cognitive development in the child, whilst optimal B vitamin status may help to prevent cognitive dysfunction in later life. The biological mechanisms explaining these relationships are not clear but may involve folate‐related DNA methylation of epigenetically controlled genes related to brain development and function. A better understanding of the mechanisms linking these B vitamins and the epigenome with brain health at critical stages of the lifecycle is necessary to support evidence‐based health improvement strategies. The EpiBrain project, a transnational collaboration involving partners in the United Kingdom, Canada and Spain, is investigating the nutrition–epigenome–brain relationship, particularly focussing on folate‐related epigenetic effects in relation to brain health outcomes. We are conducting new epigenetics analysis on bio‐banked samples from existing well‐characterised cohorts and randomised trials conducted in pregnancy and later life. Dietary, nutrient biomarker and epigenetic data will be linked with brain outcomes in children and older adults. In addition, we will investigate the nutrition–epigenome–brain relationship in B vitamin intervention trial participants using magnetoencephalography, a state‐of‐the‐art neuroimaging modality to assess neuronal functioning. The project outcomes will provide an improved understanding of the role of folate and related B vitamins in brain health, and the epigenetic mechanisms involved. The results are expected to provide scientific substantiation to support nutritional strategies for better brain health across the lifecycle. [ABSTRACT FROM AUTHOR]

There is evidence that diet and nutrition are modifiable risk factors for several cancers. In recent years, attention paid to micronutrients in gynecology has increased, especially regarding Human papillomavirus (HPV) infection. We performed a review of the literature up until December 2022, aiming to clarify the effects of micronutrients, minerals, and vitamins on the history of HPV infection and the development of cervical cancer. We included studies having as their primary objective the evaluation of dietary supplements, in particular calcium; zinc; iron; selenium; carotenoids; and vitamins A, B12, C, D, E, and K. Different oligo-elements and micronutrients demonstrated a potential protective role against cervical cancer by intervening in different stages of the natural history of HPV infection, development of cervical dysplasia, and invasive disease. Healthcare providers should be aware of and incorporate the literature evidence in counseling, although the low quality of evidence provided by available studies recommends further well-designed investigations to give clear indications for clinical practice. [ABSTRACT FROM AUTHOR]

Background & Aims: On December 12, 2019, Covid-19 an infectious disease pandemic caused by the corona virus has become a major global threat to the city of Wuhan, China. Coronaviruses are a large family of viruses that can cause disease in humans and other animals. The new coronavirus seriously attacks lung epithelial cells and causes respiratory disorders that require ventilatory support in severe cases. Elderly people, especially those with underlying diseases such as diabetes, cardiovascular diseases, respiratory diseases, and high blood pressure, such as people who have a suppressed immune system, are exposed to severe symptoms and mortality. Also, in addition to the lung tissue, the new coronavirus also targets other organs such as the heart, kidney, digestive system and brain. In the pathogenesis of this disease, there is a cytokine storm and changes in immune responses. Two factors, the uncontrolled inflammatory response and the reduction of the immune system in people with corona can cause the symptoms to worsen during and after infection. The immune system and the digestive system both play key roles in terms of access to nutrients and the defense of the host body as the intestinal microbiota against external foreign factors. Therefore, one of the biggest concerns is related to reducing inflammation and not reducing the patient's immune response, and to solve this concern, in addition to drug therapy, diet therapy should also be at the top of these approaches. The importance of proper eating patterns and habits in the Covid19 epidemic showed that this issue is not only to prevent the presence of non-communicable diseases that can subsequently lead to more severe infections but is also considered a solution for modulating the inflammatory condition of patients. It is a fact that ignoring the importance of nutrition in patients with Covid-19 leads to the worsening of symptoms and complications of the disease in these patients. Therefore, the purpose of this study is to investigate the relationship between nutrition, the body's immune system, and covid-19 to formulate appropriate food plans and patterns for prevention and improvement during treatment and after. Methods: In this review study, we have examined the importance of proper nutrition on the immune system and its effects on the prevention and treatment of covid-19 disease. For this purpose, articles from international databases such as PubMed, Google Scholar, Science Direct, and Scopus were analyzed by entering the key words of the Covid-19 pandemic, immune system, nutritional factors, and food supplements. Results: The immune system needs sufficient amounts of vitamin A for its various defense functions, such as keratin and mucus expression, cell death, growth, development, immune cell activity, antibody production, and cytokine expression against pathogens. Several studies have shown the effect of vitamin A deficiency on the disease severity of patients with coronavirus. Vitamin A and retinoid cause the secretion of compounds that inhibit virus replication in immune cells. Therefore, using this vitamin as a supplement in patients suffering from viral diseases reduces complications and mortality. This group of vitamins is an essential micronutrient that has different roles such as improving the function of the immune system and promoting the growth of cells. Also, this vitamin has an anti-inflammatory and inhibitory role in the entry of neutrophils into the damaged lung. Vitamin B6 plays a coenzyme role in T-cells production and interleukin 2. Therefore, when faced with a deficiency of group B vitamins, the immune system response in dealing with foreign agents becomes weaker. With these interpretations, group B vitamins can be considered as an auxiliary treatment in Covid-19 treatment. Vitamin C or ascorbic acid is a water-soluble vitamin that has a very strong antioxidant role, which becomes very important in the conditions of oxidative stress caused by coronaviruses. Vitamin C can strengthen the immune system and resistance against the infection caused by coronaviruses through various ways such as the migration of leukocytes to the sites of infection, phagocytosis and killing of bacteria, the activity of natural killer cells, the function of T lymphocytes (especially cytotoxic T lymphocytes) and the production of antibodies. Vitamin C supplementation has also been shown to reduce the duration and severity of upper respiratory tract infections such as the common cold, especially in people who are under severe physical stress. The role of vitamin D in bone health is known, but another essential role of this vitamin is in strengthening the response of the immune system and the growth and maturation of immune cells. Vitamin D can reduce the risk of viral infections such as coronaviruses by several mechanisms. Vitamin D moderates this process by reducing the secretion of inflammatory cytokines and increasing the expression of antiinflammatory factors. New studies also reported that by detecting the presence of the virus, vitamin D can prevent the rapid multiplication of the virus through programmed death and autophagy in tissues infected with infectious agents. Therefore, this vitamin can be effective in treating and preventing the covid-19 coronavirus in different ways. Studies related to the roles of vitamin E in host immunity and susceptibility to infection have been reported. When infected with coronaviruses, cell membranes, especially lungs, undergo oxidation of unsaturated fatty acids and subsequently increase their permeability. By maintaining the of the T-Cell membrane, vitamin E plays a significant role in improving the performance of immune system responses and clearing bacterial and viral infectious agents. Vitamin E supplementation increases antibody production, lymphocyte proliferation, T helper 1 cytokine production, natural killer cell activity, and macrophage phagocytosis. Therefore, vitamin E can be used as an effective antioxidant in the prevention and improvement of symptoms caused by Covid-19. Selenium deficiency occurs in two forms: mild deficiency and impairment of human health, and severe deficiency and defects in the response of the humoral and cellular immune system. Zinc deficiency may exacerbate the effects of Covid-19 in several ways; including by destroying the balance between innate and acquired immune cells, intensifying inflammatory responses that can lead to failure of various organs, excessive thrombus formation that can lead to an increased risk of thromboembolism, and finally, by reducing the function of the mucous barrier in many organs and tissues. Therefore, the nutrient zinc can be helpful for the optimal functioning of the immune system when the symptoms of the disease of Covid-19 appear in affected people. The favorable effect of iron on the functioning of the immune system and protection against foreign factors is well known. Probiotics, especially some lactobacilli and bifidobacteria, reduce the incidence of respiratory infections in humans and improve their consequences. However, a total of the evidence suggests that lactobacilli and bifidobacteria may improve immune function. The role of probiotics in the prevention of viral respiratory infections has also been recently noticed. Even though oral probiotic supplements are not currently part of any specific protocol for the treatment and prevention of respiratory viral infections, many studies have shown that their use can be beneficial in modulating the systemic immune system. Conclusion: Considering that a proper diet is effective in all diseases, including cardiovascular diseases, cancer, and metabolic diseases, there is no doubt that nutrition is also important in infectious diseases. A suitable diet that contains helpful macronutrients and micronutrients, by affecting homeostasis in immune cells, maintains their function throughout life and strengthens immune mechanisms, especially in people at risk like the elderly, pregnant women, and children, and is a key element in improving the functioning of the immune system and strengthening resistance against viral and microbial infections. Therefore, insufficient lack of nutrients inception such as zinc, selenium, iron, vitamins A, B, C, D, and E, proteins, and omega-3 fatty acids can cause weak immune responses and make people susceptible to infectious diseases such as covid-19. [ABSTRACT FROM AUTHOR]

Background: Inflammation and oxidative stress are two hallmarks of periodontitis. Retinol is an antioxidant and suppresses expression of pro-inflammatory factors. However, the evidence for an association between retinol intake and periodontitis is limited. Thus, the aim of this study is to assess the association between retinol intake and periodontal health. Methods: Data used in this cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) 2009–2014 (n = 9081). Dietary intake of retinol was measured based on two 24-h dietary recall interviews. The category of periodontitis was defined by the CDC/AAP according to clinical periodontal parameters. Univariate and multivariate logistic regression analyses were applied to investigate the relationship between retinol intake and the risk of periodontitis. Results: Compared with the lowest tertile, individuals in the highest tertile of retinol intake were less likely to be periodontitis (ORtertile3vs1 = 0.79, 95% CI: 0.65–0.96). The association was still significant in populations who were less than 60 years old (ORtertile3vs1 = 0.80, 95% CI: 0.65–0.97), non-Hispanic black (ORtertile3vs1 = 0.62, 95% CI: 0.42–0.94), PI ≤ 1.3 (ORtertile3vs1 = 0.72, 95% CI: 0.55–0.93), 1.3 < PI ≤ 3.5 (ORtertile3vs1 = 0.70, 95% CI: 0.55–0.89), non-smoker (ORtertile3vs1 = 0.63, 95% CI: 0.48–0.81), obesity (ORtertile3vs1 = 0.68, 95% CI: 0.49–0.94) and who had not diabetes mellitus (ORtertile3vs1 = 0.79, 95% CI: 0.65–0.95) or had hypertension (ORtertile3vs1 = 0.63, 95% CI: 0.47–0.84). Conclusion: Retinol intake is inversely associated with poor periodontal health in US adults. [ABSTRACT FROM AUTHOR]

Purpose: Vitamin A is an essential nutrient with vital biological functions. The present study investigated the effect of different doses of vitamin A palmitate at different time intervals on thyroid hormones and glycemic markers. Methods: Male rats were administrated vitamin A palmitate at different doses (0, 0.7, 1.5, 3, 6, and 12 mg/kg, oral) and samples were collected at different time intervals of 2, 4, and 6 weeks. The levels of vitamin A, thyroid hormones (T3, T4, and TSH), deiodinases (Dio1 and Dio3), glycemic markers (blood insulin and fasting glucose levels, HOMA IR and HOMA β), retinol-binding protein 4 (RBP4) and the gluconeogenic enzyme phosphoenolpyruvate carboxykinase (PEPCK) were measured. Results: The findings demonstrated that long-term supplementation with high doses of vitamin A palmitate resulted in hypothyroidism (lower T3 and T4 levels and elevated TSH levels) as well as upregulation of Dio1 and Dio3 expression levels. This effect was associated with elevated glucose and insulin levels, enhanced HOMA IR, and decreased HOMA B index. In addition, prolonged vitamin A supplementation significantly increased RBP4 levels that upregulated the expression of PEPCK. Conclusion: High doses of vitamin A supplementation increased the risk of hypothyroidism, modulated insulin sensitivity, and over a long period, increased the incidence of type 2 diabetes mellitus associated with oxidative stress and hepatitis. [ABSTRACT FROM AUTHOR]

The article discusses the decreased vaccine coverage against diseases such as measles and mumps has led to new vulnerabilities in pediatric population health. Topics include global epidemiology of measles; concerns regarding measles and mumps, clinical manifestations and complications of each, diagnostic and treatment options, and, ultimately, prevention of further exposures, and numerous cases and outbreaks have taken root in the U.S.

Context Nutritional interventions for newborns with brain injury are scarce, and there are gaps in the knowledge of their mechanisms of action in preventing the occurrence of cerebral palsy (CP) or the incidence of other developmental disabilities. Objective The objective of this review was to assess the effect of nutritional interventions in preventing nonprogressive congenital or perinatal brain injuries, or in improving outcomes related to neurological development. Data Sources Randomized trials on any nutritional intervention for pregnant women at risk of preterm delivery, or for children with low birth weight, preterm, or with confirmed or suspected microcephaly, CP, or fetal alcohol syndrome disorders (FASDs) were retrieved from MEDLINE, Embase, Scopus, Web of Science, LILACS, and CENTRAL databases from inception to September 17, 2020. Data Extraction Data extraction, risk of bias (Cochrane Risk of Bias tool 2), and quality of evidence (GRADE approach) were assessed by 2 authors. Data Analysis Pooled risk ratios (RRs) with 95% confidence intervals were calculated using a random-effects meta-analysis. Seventeen studies were included on intravenous interventions (magnesium sulfate [n = 5], amino acids [n = 4], vitamin A [n = 1], and N-acetylcysteine [n = 1]); enteral interventions (vitamin D [n = 1], prebiotic [n = 1], nutrient-enriched formula [n = 1], and speed of increasing milk feeds [n = 1]); and oral interventions (choline [n = 1] and docosahexaenoic acid, choline, and uridine monophosphate [n = 1]). All studies assessed CP, except 1 on FASDs. Eight studies were judged as having high risk of bias. Five studies (7413 babies) with high-quality evidence demonstrated decreased risk of childhood CP (RR = 0.68, 95% CI: 0.52–0.88) with magnesium sulfate. Interventions with amino acids had no effect on CP prevention or other outcomes. Except for 1 study, no other intervention decreased the risk of CP or FASDs. Conclusion Although different types of nutritional interventions were found, only those with antenatal magnesium sulfate were effective in decreasing CP risk in preterm infants. Well-designed, adequately powered randomized clinical trials are required. [ABSTRACT FROM AUTHOR]

Objective: Ready to eat fried liver meat balls (LMB) were developed to fight anaemia and vitamin A deficiency and promote cognitive function.Design: Randomised controlled trial consisting of two arms: control group with no supplement and LMB group receiving LMB supplement three times a week for 90 d. Criteria of evaluations included dietary assessment, anthropometric measurements, laboratory investigations and cognitive function by Wechsler test.Setting: Kinder Garten and primary school in Urban Giza.Participants: Sixty boys and girls aging 3-9 years.Results: The LMB supplement contributed to significant increases in the intakes of high bioavailable Fe and vitamin A in the diets of all children. Initial overall prevalence of mild and moderate anaemia was 43 %, which disappeared completely from all children aging < 72 months and from 88 % of children ≥ 72 months after the 90 d dietary intervention with the LMB. Faecal systemic immune globulin A, urinary hydroxyproline index and urinary iodine excretion increased significantly (P < 0·05) only after the dietary intervention with the LMB supplement for 90 d. The standard scores of verbal and non-verbal cognitive function tests (Δ day 90-day 0) increased significantly (P < 0·05) among the LMB group compared with the respective changes observed among the control group. The increase in height-for-age Z score and blood Hb were good predictors for improvement in cognitive function.Conclusion: LMB supplement is effective sustainable nutritious biotherapeutic food in fighting hidden hunger and promoting the cognitive function. [ABSTRACT FROM AUTHOR]

Background In 2018-2019, large outbreaks of measles occurred in Israel and in New York City, driven in part by travel of unimmunized children between the 2 communities. Methods A retrospective chart review was conducted for children tested for measles (March 2018-September 2019) at NYU Langone Health in New York, NY, and in Ramla subdistrict, Israel. Vaccination records were reviewed to determine vaccination status for measles, mumps, and rubella (MMR) at the time of measles testing and 1-year post-testing. Results A total of 264 children were tested for measles, and 102 (38.6%) had confirmed measles. Only 20 (19.6%) of measles-positive cases received a full 2-dose course of vitamin A. 82.4% of children with measles were ≥1 year at the time of diagnosis and fully eligible for MMR vaccine. Of the 100 measles-positive cases with available vaccine records, 63 were unvaccinated at testing, and 27 remained unimmunized against MMR 1 year later. At testing, measles-negative children were significantly more likely to have received MMR than measles-positive children (65.4% vs 37%, P  < .01). One year later, 70.4% of measles-negative cases and only 57.1% of measles-positive cases had received MMR vaccine (P  = .18). Conclusions The majority of measles cases occurred in unimmunized children eligible for vaccination, and >25% of children in both measles-positive and -negative groups remained unimmunized for MMR 1-year post-outbreak. Our results suggest the need for novel, longitudinal vaccination strategies and increased awareness of the role of vitamin A. [ABSTRACT FROM AUTHOR]

Emma Soos presents a case study on a recent facial trauma caused by machinery and the results of a program of intense light-emitting diode (LED) 3 wavelength therapy using the Silvery Blue LED system, followed by a course of medical/cosmetic needling with appropriate serums to promote healing [ABSTRACT FROM AUTHOR]

Importance: Cardiovascular disease and cancer are the 2 leading causes of death in the US, and vitamin and mineral supplementation has been proposed to help prevent these conditions.Objective: To review the benefits and harms of vitamin and mineral supplementation in healthy adults to prevent cardiovascular disease and cancer to inform the US Preventive Services Task Force.Data Sources: MEDLINE, PubMed (publisher-supplied records only), Cochrane Library, and Embase (January 2013 to February 1, 2022); prior reviews.Study Selection: English-language randomized clinical trials (RCTs) of vitamin or mineral use among adults without cardiovascular disease or cancer and with no known vitamin or mineral deficiencies; observational cohort studies examining serious harms.Data Extraction and Synthesis: Single extraction, verified by a second reviewer. Quantitative pooling methods appropriate for rare events were used for most analyses.Main Outcomes and Measures: Mortality, cardiovascular disease events, cancer incidence, serious harms.Results: Eighty-four studies (N=739 803) were included. In pooled analyses, multivitamin use was significantly associated with a lower incidence of any cancer (odds ratio [OR], 0.93 [95% CI, 0.87-0.99]; 4 RCTs [n=48 859]; absolute risk difference [ARD] range among adequately powered trials, -0.2% to -1.2%) and lung cancer (OR, 0.75 [95% CI, 0.58-0.95]; 2 RCTs [n=36 052]; ARD, 0.2%). However, the evidence for multivitamins had important limitations. Beta carotene (with or without vitamin A) was significantly associated with an increased risk of lung cancer (OR, 1.20 [95% CI, 1.01-1.42]; 4 RCTs [n=94 830]; ARD range, -0.1% to 0.6%) and cardiovascular mortality (OR, 1.10 [95% CI, 1.02-1.19]; 5 RCTs [n=94 506] ARD range, -0.8% to 0.8%). Vitamin D use was not significantly associated with all-cause mortality (OR, 0.96 [95% CI, 0.91-1.02]; 27 RCTs [n=117 082]), cardiovascular disease (eg, composite cardiovascular disease event outcome: OR, 1.00 [95% CI, 0.95-1.05]; 7 RCTs [n=74 925]), or cancer outcomes (eg, any cancer incidence: OR, 0.98 [95% CI, 0.92-1.03]; 19 RCTs [n=86 899]). Vitamin E was not significantly associated with all-cause mortality (OR, 1.02 [95% CI, 0.97-1.07]; 9 RCTs [n=107 772]), cardiovascular disease events (OR, 0.96 [95% CI, 0.90-1.04]; 4 RCTs [n=62 136]), or cancer incidence (OR, 1.02 [95% CI, 0.98-1.08]; 5 RCTs [n=76 777]). Evidence for benefit of other supplements was equivocal, minimal, or absent. Limited evidence suggested some supplements may be associated with higher risk of serious harms (hip fracture [vitamin A], hemorrhagic stroke [vitamin E], and kidney stones [vitamin C, calcium]).Conclusions and Relevance: Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use. Beta carotene was associated with an increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer. [ABSTRACT FROM AUTHOR]

Bronchopulmonary dysplasia (BPD) is one of the major causes of chronic respiratory diseases among infants. Both pharmacological and nonpharmacological approaches have been proposed for its management. Since oxidative stress is known to play a pivotal role in the pathogenesis of BPD, it is reasonable to consider the potential of antioxidant strategies in the prevention and treatment of this condition. Indeed, antioxidants can prevent or inhibit substrate oxidation. Some studies have evaluated the efficacy of the exogenous administration of vitamins and micronutrients in reducing the propagation of free radicals through their scavenging capacity. Nonetheless, encouraging preclinical results did not translate into effective preventive and/or therapeutic interventions. This narrative review evaluates the current evidence about the antioxidants that are potentially useful for preventing and treating BPD and explores the most relevant issues affecting their implementation in clinical practice, as well as their associated evidence gaps and research limitations. [ABSTRACT FROM AUTHOR]

During the infection and treatment of the SARS-CoV-2 viral infection, age and comorbidities play a major role in the successful management of COVID-19. The nutritional status changes which occur in the body vary with the age and underlying conditions and has a vital role in the functioning of the immune system and cellular membrane integrity, thus minimizing the vulnerability to the infection. Considering the data already published by eminent researchers, a few micronutrients have shown outstanding results as supportive therapies in the treatment of viral infections. Micronutrient like zinc improves the membrane barrier integrity, has anti-inflammatory activity, and is involved in antibody production. Vitamin A supports the phagocytic activity of macrophages, while vitamin C reduces the worsening of respiratory tract infections by restoring the dysfunctional epithelial barrier of the lungs. Vitamin D, vitamin E, selenium, and omega-3 fatty acid metabolites play a major role in immunomodulation and in the inhibition of proinflammatory cytokine production. Magnesium is involved in the synthesis of antibodies, while copper, vitamin B12, and folate have significant effects on immune cells. A few researchers suggest that iron supplementation has reduced the risk of acquiring respiratory tract infections in children. As the age of the patient increases, the need for micronutrients increases, thus leading to an imbalanced nutritional status which in turn increases the risk and fatality of the infections. The use of micronutrients in modulating the inflammatory, immune responses, and the epithelial barrier integrity is explored during the treatment of viral infections for faster recovery. [ABSTRACT FROM AUTHOR]

The article focuses on adjunctive vitamin A and D for the glycaemic control in patients with concurrent type 2 diabetes and tuberculosis a randomised controlled trial.

Background. Antioxidants attracted long-standing attention as promising preventive agents worldwide. Previous observational studies have reported that circulating antioxidants are associated with reduced mortality; however, randomized clinical trials indicate neutral or harmful impacts. The association of long-term circulating antioxidant exposure with longevity is still unclear. Objectives. We aim to determine whether long-term circulating antioxidant exposure is causally associated with longevity in the general population using the two-sample Mendelian randomization (MR) design. Methods. Genetic instruments for circulating antioxidants (ascorbate, lycopene, selenium, beta-carotene, and retinol) and antioxidant metabolites (ascorbate, alpha-tocopherol, gamma-tocopherol, and retinol) were identified from the largest up-to-date genome-wide association studies (GWASs). Summary statistics of these instruments with individual survival to the 90th vs. 60th percentile age (11,262 cases and 25,483 controls) and parental lifespan (N = 1,012,240 individuals) were extracted. The causal effect was estimated using the inverse-variance weighted method in the main analysis and complemented by multiple sensitivity analyses to test the robustness of results. Results. We found that genetically determined higher concentration of circulating retinol (vitamin A) metabolite was casually associated with a higher odds of longevity (OR, 1.07; 95% CI, 1.02–1.13; P < 0.01) and increased parental lifespan (lifespan years per 10-fold increase: 0.17; 95% CI, 0.07–0.27; P < 0.01). Present evidence did not support a causal impact of circulating ascorbate (vitamin C), tocopherol (vitamin E), lycopene, selenium or beta-carotene on life expectancy. No evidence was identified to show the pleiotropic effects had biased the results. Conclusions. Long-term higher exposure to retinol metabolite is causally associated with longevity in the general population. Future MR analyses could assess the current findings further by utilizing additional genetic variants and greater samples from large-scale GWASs. [ABSTRACT FROM AUTHOR]

Recently, vitamins have been shown to act as epigenetic modifier. Cancer cells exhibit transcriptional downregulation of NK group 2D ligands (NKG2DLs) through repressive methylation and are largely resistant to NK cell-mediated eradication. We herein investigated the potential of recently reported epigenome modifying vitamins A, C, and E in inducing the expression of epigenetically silenced NKG2DLs in cancer cells. Based on the cell viability assay three concentrations, i.e., 25, 50, and 100 µg/ml of all vitamins were selected for treatment. Results showed that treatment of both vitamin A and C significantly upregulates expression of two major NKG2DLs namely MICA and MICB. Simultaneously, both, vitamin A and C significantly reduces the methylation process by downregulating DNA methyltransferases (DNMTs) expression level. Vitamin C, but not vitamin A, significantly upregulates TETs (DNA demethylases) expression. Further, we assessed the impact of both vitamins A and C on S-adenosylmethionine/S-adenosylhomocysteine (SAM/SAH) ratio levels and found no significant changes in SAM/SAH ratio. Overall, we clearly found that both vitamin A and C induces NKG2DLs mostly through repressing the expression of DNMTs, suggesting their potential role in improving the targeting of tumor cells by promoting the engagement and clearance of tumor cells with NK cells. [ABSTRACT FROM AUTHOR]

Background A previous systematic review showed that intramuscular vitamin A supplementation reduced the risk of bronchopulmonary dysplasia (BPD) in very-low-birth-weight (VLBW) infants. However, more recent studies have questioned this finding. Objectives Our objective was to synthesize current evidence on vitamin A supplementation in very-preterm (<32 wk gestational age) or VLBW infants and investigate the factors that may modify its efficacy. Methods A systematic review was conducted using the Cochrane systematic review methodology. We included randomized controlled trials investigating vitamin A supplementation for reducing morbidity and mortality in very-preterm or VLBW infants. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) recommendations. Prespecified subgroup analyses assessed factors that may modify the effects of vitamin A supplementation. Results We included 17 studies (n  = 2471) in the qualitative and 15 studies (n  = 2248) in the quantitative synthesis. Moderate-certainty evidence suggested a beneficial effect of vitamin A for decreasing the risk of BPD at 36 wk postmenstrual age (RR: 0.83; 95% CI: 0.74, 0.93; numbers needed to treat for an additional beneficial outcome: 16; 95% CI: 9, 53; 9 studies, n  = 1752; P  = 0.002). Subgroup analysis suggested that the beneficial effect was limited to infants with baseline vitamin A intake <1500 IU · kg−1 · d−1. Both enteral and parenteral routes were effective. Vitamin A supplementation did not have adverse effects and did not alter mortality before discharge (12 studies, n  = 1917) or neurodevelopmental outcomes at 18–22 mo (1 study, n  = 538). Conclusions The benefit of vitamin A supplementation for reducing BPD is likely to be limited to infants with baseline vitamin A intake <1500 IU · kg−1 · d−1 and is not affected by the route of administration. [ABSTRACT FROM AUTHOR]

Achieving adequate micronutrient status, while avoiding deficiencies, represents a challenge for people globally. Consequently, many individuals resort to oral nutrient supplementation (ONS) in order to correct suboptimal dietary intakes. Advances in the fields of nutrigenetics and nutritional genomics have identified differences in response to micronutrient supplementation according to genetic makeup, adding dietary supplement use to the clinician's toolkit in the precision nutrition era. This review focuses on published evidence linking genetic variants to the responses associated with some of the most popular dietary supplements. With an increasing number of health professionals becoming involved in the prescription of ONS, identifying and matching individuals to the appropriate dietary supplement according to their genotype is important for achieving optimal health benefits and micronutrient equilibrium, while reducing the adverse events and financial costs often associated with excessive ONS. [ABSTRACT FROM AUTHOR]

Vitamin A supplementation (VAS), started as a short‐term strategy pending dietary improvements, has been implemented in Ethiopia for the last 15 years. We aimed to describe the trends in VAS coverage and estimated the associated reductions in child mortality. VAS coverage data obtained from the District Health Information System and the Demographic and Health Surveys were linked to child mortality data from the United Nations Interagency Group for Child Mortality Estimation (UN IGME). The number of child deaths averted was modelled assuming 12% and 24% reductions in all‐cause mortality. From 2006 to 2011, VAS was delivered through campaigns, and coverage was above 85%. However, from 2011 onwards, VAS delivery was integrated to the routine health system, and the coverage declined to <60% with significant disparities by wealth quintile and rural–urban residence. VAS has saved between 167,563 to 376,030 child lives (2005–2019), but additional lives (>42,000) could have been saved with a universal coverage (95%). Inconsistent supply of vitamin A capsules, but more importantly, low access to health care, and the limited contact opportunities for children after 24 months may have contributed to the declining VAS coverage. Any changes in target or scale‐up should thus consider these spatial and socioeconomic variations. Increasing the coverage of VAS and closing the equity gap in access to nutrition services is critical. However, with alternative programmes like vitamin A fortification being set‐up, the benefits and safety of VAS need to be closely monitored, particularly in areas where there will be overlap. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Evidence suggests that intramuscular vitamin A reduces the risk of abstract bronchopulmonary dysplasia (BPD) in preterm infants. Our objective was to compare enteral water-soluble vitamin A with placebo supplementation to reduce the severity of BPD in extremely preterm infants. METHODS: We conducted a double-blind randomized controlled trial in infants <28 weeks' gestation who were to receive either enteral water-soluble vitamin A (5000 IU per day) or a placebo. Supplementation was started within 24 hours of introduction of feeds and continued until 34 weeks' postmenstrual age (PMA). The primary outcome was the severity of BPD, assessed by using the right shift of the pulse oximeter saturation versus the inspired oxygen pressure curve. RESULTS: A total of 188 infants were randomly assigned. The mean 6 SD birth weight (852 6 201 vs 852 6 211 g) and gestation (25.8 6 1.49 vs 26.0 6 1.39 weeks) were comparable between the vitamin A and placebo groups. There was no difference in the right shift (median [25th-75th percentiles]) of the pulse oximeter saturation versus inspired oxygen pressure curve (in kilopascals) between the vitamin A (11.1 [9.5-13.7]) and placebo groups (10.7 [9.5-13.1]) (P = .73). Enteral vitamin A did not affect diagnosis of BPD or other clinical outcomes. Plasma retinol levels were significantly higher in the vitamin A group versus the placebo group on day 28 and at 34 weeks' PMA. CONCLUSIONS: Enteral water-soluble vitamin A supplementation improves plasma retinol levels in extremely preterm infants but does not reduce the severity of BPD. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Vitamin A in the immune system is considered as an anti-inflammatory vitamin that has anti-infective effects in infectious diseases. Therefore, this study was performed to evaluate the effectiveness of vitamin A as one of the complementary therapies in the treatment of brucellosis. METHODS: In this experimental study, 110 people were selected as brucellosis patients based on serological test and were placed in two groups of control and intervention. In addition to the usual drugs for the treatment of brucellosis, patients in the intervention group received oral vitamin A at a dose of 25,000 units pre day for 6 weeks, and patients in the control group did not receive vitamin A. After the intervention, the response to treatment was evaluated based on the number of days of fever, chills, sweating, arthralgia, myalgia, anorexia, chronicity and recurrence using standard methods in the two groups. FINDINGS: In terms of days with fever (14.72±27.61 vs. 53.45±141.14), sweating (19.27±28.98 vs. 61.09±142.35), arthralgia (56±96.83 vs. 53.45±158.18), myalgia (13.45±27.23 vs. 52.36±141.44) and anorexia (13.30±47.39 vs. 51.81±129.8), a significant decrease was observed in the intervention group compared to the control (p<0.05). There was no difference between the intervention and control groups in terms of chills (p=0.122). The recurrence rate in the control and intervention groups was 25.5% and 7.3%, respectively, and the chronicity rate was 3.6% and 0%, respectively, which was statistically significant (p<0.05). CONCLUSION: Based on the results of the study, it can be said that vitamin A leads to faster improvement of brucellosis symptoms and it can be used as a complementary treatment for brucellosis. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has sparked an increase in claims that particular food and drink products and nutritional supplements are able to 'boost' immunity. The immune system is highly complex, consisting of many different cell types and processes, and nutritional adequacy is undoubtedly required to support its function. Specific roles have been established for several micronutrients including vitamins A, B6, B12, C and D, copper, folate, iron, selenium and zinc, with documented impacts on particular aspects of immune function as a result of clinical deficiencies. Increased susceptibility to infections and poorer outcomes have been commonly observed in cases of undernutrition. However, high bodyweight, diabetes and ageing are also associated with immune dysfunction. The gut microbiota is intimately linked with the immune system and there is some evidence to suggest that food components that favourably modify its composition, such as pre‐ and probiotics, may be advantageous in immune modulation. Studies also indicate some benefits of specific supplements; for example, zinc and vitamin C supplements have been shown to reduce the duration of the common cold; probiotics have been suggested to reduce the duration and severity of acute infectious diarrhoea and prevent antibiotic‐associated diarrhoea; and anti‐inflammatory effects of long‐chain omega‐3 fatty acids have also been demonstrated. However, at present there are no authorised EU health claims for any of these effects. In the light of the recent media interest in the role of diet and lifestyle on the immune system following the COVID‐19 outbreak, this article will summarise why a healthy, balanced diet is key to supporting immune function with consideration given to the latest thinking in relation to COVID‐19. [ABSTRACT FROM AUTHOR]

Abetalipoproteinaemia (ABL) is an autosomal recessive disorder characterized by very low plasma concentrations of total cholesterol and triglyceride (TG). It results from mutations in the gene encoding microsomal TG transfer protein (MTTP). A nine-month-old girl was admitted to hospital because of fever, cough, diarrhea and failure to thrive. She had low cholesterol and TG levels according to her age. The peripheral blood smear revealed acanthocytosis. Thyroid function test showed central hypothyroidism. Cranial magnetic resonance imaging revealed the retardation of myelination and pituitary gland height was 1.7 mm. A homozygous novel mutation [c.506A>T (p.D169V)] was detected in the MTTP gene. Vitamins A, D, E, and K and levothyroxine were started. The coexistence of ABL and central hypothyroidism has not previously been reported. A homozygous novel mutation [c.506A>T (p.D169V)] was detected in the MTTP gene. [ABSTRACT FROM AUTHOR]

Background: Vitamin A plays an important role in vision, cellular differentiation, embryonic development, reproduction, growth and the immune system. Women who live in developing countries face a risk of undernutrition during pregnancy as a result of poverty, poor diet quality and quantity, and a high fertility rate. This poor dietary problem could reflect the high risk of vitamin A deficiency in women. The present study aimed to determine the adequacy of vitamin A among pregnant women following antenatal care in health facilities of Dessie Town, Ethiopia, January 2017. Methods: Health facility‐based cross‐sectional study was conducted among 390 women who attended antenatal care in Dessie Town. Food groups from the Food and Agriculture Organization based on 24‐h dietary recall were used to measure dietary intake of vitamin A and dietary diversity of women. Adequacy of vitamin A was determined from the nutrient adequacy ratio after obtaining reports of nutrient intake from food composition tables version III and IV in terms of B carotene and retinol equivalent, respectively, based on the estimated average requirement recommendation of vitamin A, 370 retinol equivalent day−1 for pregnant women. Multivariable logistic regression analysis was performed to identify associated factors of vitamin A adequacy. Results: Adequacy of vitamin A among pregnant women was 41.8%, with an average nutrient adequacy ratio of 0.9. The mean dietary intake of vitamin A was 290.1 µg day–1. The predictors for adequacy of vitamin A were high and medium women diversity scores (adjusted odds ratio = 2.92; 95% confidence interval = 1.50–5.70) and (adjusted odds ratio = 1.87; 95% confidence interval = 1.11–3.16). Conclusions: In the present study, adequacy of vitamin A was low and was affected by the dietary diversity score. A focus on food‐based approaches, especially regarding educating pregnant women to diversify their diet, is crucial for reducing the risk of vitamin A deficiency. Vitamin A is crucial micronutrient for the health of women and fetus, being essential for morphological, ocular and functional developments, as well as fetal organ and skeletal growth. Its requirement is greater during pregnancy and its deficiencies lead to maternal and child mortality and development. The dietary intake of vitamin A among pregnant women remains below the current recommendation. Inadequate intake of vitamin APregnant womenHeath facilityDessie, Ethiopia [ABSTRACT FROM AUTHOR]

Objective: Individuals with obesity suffer from an increased susceptibility to severe respiratory viral infections and respond poorly to vaccinations, making it imperative to identify interventions. Recent evidence suggesting that obesity leads to tissue-specific vitamin A deficiency led to an investigation of whether high-dose oral vitamin A, a treatment used for remediating vitamin A deficiency in developing countries, could correct obesity-associated tissue deficits.Methods: Adult C57BL/6 diet-induced obese mice were supplemented with vitamin A for 4 weeks. A subset of mice were then vaccinated with inactivated influenza virus and challenged. Following supplementation, tissue vitamin A levels, lung immune cell composition, blood inflammatory cytokines, antibody responses, and viral clearance were evaluated.Results: Supplementation significantly improved vitamin A levels in lung and adipose tissues in diet-induced obese mice. Additionally, supplementation decreased inflammatory cytokines in the blood and altered the lung immune environment. Importantly, vaccinated, vitamin A-treated diet-induced obese mice exhibited improved antibody responses and significantly reduced viral loads post challenge compared with PBS-treated mice.Conclusions: Results demonstrate a low-cost intervention that may correct vitamin A tissue deficits and help control respiratory viral infections in individuals with obesity. [ABSTRACT FROM AUTHOR]

Introduction: Although several social interventions have been developed by the Peruvian State, anemia is present in one out of every two children in Peru. Thus, it is important to evaluate whether such interventions are achieving their objectives. Objective: This study aimed to determine the association of nutritional status and anemia with multi-micronutrient supplementation in children younger than three years in Huancayo, Peru. Materials and Methods: This retrospective, longitudinal, analytical, and observational study included secondary data of children younger than 3 years from the Sicaya District, in the Huancayo province. Data were collected from health center medical records. Nutritional and anemia status, and sociodemographic characteristics of children receiving multi-micronutrient supplementation were recorded. Statistical analyses were based on generalized linear models. Results: Data of 76 children with available medical records were analyzed, and their pre- and post-intervention median ages were 6 and 11 months (range: 7-35 months), respectively. Significant positive linear correlations were observed between the number of multi-micronutrient doses and weight, height, and hemoglobin concentration. In bivariate and multivariate analyses, no significant associations were observed between anthropometric measurements and anemia (after multi-micronutrient intervention) (p>0.05), nor between the number of received doses of multi-micronutrients, sex, and age. Conclusion: Multi-micronutrient supplementation may be correlated with both physiological and anthropometric variables, but not with indicators of child development. These associations require further evaluations to determine whether social programs promoting multi-micronutrient supplementation improve the development of children with anemia. [ABSTRACT FROM AUTHOR]

Dietary antioxidants are widely distributed in various types of our food. They are strongly associated with reduced risk of many chronic diseases such as atherosclerosis, cancer, and Alzheimer's diseases. They include vitamins such as vitamins A, E, C, and carotenoids. Also, some minerals like; zinc, manganese, copper, iron, and selenium are essential for the activity of antioxidant enzymes. Furthermore, dietary polyphenols and flavonoids are considered as potent antioxidant compounds. Vegetables, fruits, and edible herbs are the richest sources of such antioxidants. Antioxidants reduce oxidative stress, either directly by reducing reactive species or indirectly by enhancing the body antioxidant defense mechanisms in different ways. These may include upregulating gene expression of some antioxidant enzymes via a nuclear factor erythroid 2 related factor2 pathway. Administration of a mixture of antioxidants is beneficial since they act synergistically in various phases. The aims of this review are to summarize the different antioxidants from dietary sources and their role in the prevention of different diseases. [ABSTRACT FROM AUTHOR]

This randomized double-blind placebo-controlled trial evaluated the effects of early postnatal oral vitamin A supplementation (VAS) in 196 inborn very-low birth weight (VLBW) infants requiring respiratory support at 24 h of age. Eligible infants were randomized to receive aqueous syrup of vitamin A (10,000 IU of retinol/dose; n = 98) or placebo (n = 98) on alternate days for 28 days. Primary outcome variable was composite incidence of all-cause mortality and/or oxygen requirement for 28 days. Secondary outcome variables were safety/tolerability of VAS, serum retinol concentration at recruitment and day 28, duration of oxygen requirement and respiratory support and incidences of complications. On intention-to-treat analysis, composite incidence of all-cause mortality and oxygen requirement for 28 days was significantly lower in vitamin A group (relative risk (95% confidence interval), 0.440 (0.229-0.844); p < 0.05, number needed to benefit, 7). Requirement and duration of oxygen supplementation and non-invasive respiratory support, incidences of late-onset sepsis, patent ductus arteriosus, and duration of hospital stay were also significantly lower in vitamin A group. Serum retinol concentration improved significantly after VAS. No major adverse effect was observed.Conclusions: Early postnatal oral VAS was associated with better composite outcome of all-cause mortality and oxygen requirement without any major adverse effects.Clinical Trial Registration: Clinical Trials Registry of India (CTRI/2017/03/008131). What is Known: • Postnatal intramuscular vitamin A supplementation improves the survival, respiratory outcome and other morbidities in very low birth weight neonates without major adverse effects. • Limited studies on oral vitamin A supplementation did not document substantial benefits. What is New: • Early postnatal alternate-day oral vitamin A supplementation at the dose of 10,000 IU/dose for 28 days improves the composite outcome of death and oxygen requirement in very low birth weight neonates with respiratory distress • No major adverse effects were documented. [ABSTRACT FROM AUTHOR]

Objectives: This analysis documents the use of conventional health-care providers, traditional healers, and complementary therapies by Mexican farmworkers; identifies the purposes and perceived helpfulness of these modalities; and delineates variation in the use of traditional healers and complementary therapies. Methods: Two-hundred Mexican farmworkers in North Carolina completed interviews May–September, 2017. The International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) elicited use of conventional health-care providers, traditional healers, and complementary therapies in the previous 12 months. Results: Most of the farmworkers had been treated by a conventional provider (63.0%). One-in-five had been treated by any traditional healer; 19.5% had been treated by a sobador, 4.5% by a curandero, 2.0% by an herbalist, and 2.0% by a spiritual healer. Conventional providers (69.8%) and sobadores (84.6%) most often treated acute conditions; 62.5% had used an herb, 46.0% a vitamin, 57.0% an over-the-counter medicine, and 13.5% a home remedy. Participants used various self-care practices, including music (36.5%), sleep (18.0%), prayer for health (15.0%), and social media (14.0%). Education was inversely associated with the use of a traditional healer and herbs; treatment by a conventional health-care provider was positively associated with using a traditional healer and vitamins. Conclusions: Mexican farmworkers use conventional health-care providers as well as traditional healers and complementary therapies. Research on how use of complementary therapies and a system of medical pluralism affects farmworker health is needed. Health-care providers need to recognize complementary therapy use and provide patient education about ineffective or harmful therapies. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to give an overall view of the pattern of high-dose vitamin A supplementation (VAS) coverage in twenty-three sub-Saharan African countries and factors associated with receipt of VAS among children aged 6-59 months.Design: Cross-sectional data from the twenty-three Demographic and Health Surveys conducted from 2011 to 2015 in twenty-three sub-Saharan African countries were pooled. A multilevel logistic regression model was used to explore factors associated with VAS.Setting: Twenty-three sub-Saharan African countries.ParticipantsChildren (n 215 511) aged 6-59 months.Results: The overall coverage of VAS among children aged 6-59 months for the surveys included was 59·4 %. In the multivariable analysis, children whose mothers had primary (adjusted OR (aOR)=1·43; 95 % CI 1·39, 1·47) or secondary or above (aOR=1·72; 95 % CI 1·67, 1·77) educational status were more likely to receive VAS than children whose mothers had no formal education. Other factors associated with significantly increased likelihood of VAS were: living in urban areas; children of working mothers; children whose mothers had higher media exposure; children of older mothers v. children of mothers aged 15-19 years; and older children v. children aged 6-11 months. At the country level, lower media exposure was significant and negatively associated with VAS.Conclusions: Broader VAS coverage is needed according to our data. More efforts are needed to scale up coverage, focusing mostly on groups at risk of non-receipt of vitamin A. [ABSTRACT FROM AUTHOR]

Bronchopulmonary dysplasia (BPD) is a morbidity of prematurity with implications for respiratory and neurologic health into adulthood. Multiple risk factors contribute to the development of BPD leading to examination of various prevention strategies. The roles of systemic corticosteroids and caffeine have been addressed by the American Academy of Pediatrics. The place in therapy of other agents commonly utilized in clinical practice remains unclear. Inhaled nitric oxide has been the subject of numerous large, randomized controlled trials in preterm infants. Despite sound rationale, these trials have largely failed to document benefit, suggesting a limited role for inhaled nitric oxide therapy in the preterm population. In contrast, intramuscular vitamin A has been documented to reduce the incidence of BPD in randomized trials. However, the invasiveness and the sporadic availability of this therapy have led to decreased utilization. All macrolide antibiotics do not appear to have a similar impact on the incidence of BPD; however, azithromycin administered to infants colonized with Ureaplasma may have impact. Questions remain about the optimal dosing approach and long-term safety of this intervention. Finally, diuretic therapy is widely used in clinical practice despite significant toxicities and limited data supporting a role in BPD prevention. Taken together, available data suggest that caffeine and selective use of corticosteroids remain the mainstays of pharmacologic BPD prevention. [ABSTRACT FROM AUTHOR]

Introduction. Vitamin A is an essential substance for human well-being and survival. It plays a crucial role in many physiological processes, including growth and differentiation of target tissues, reproduction, proper functioning of the retina and modulation of the immune system. Vitamin A deficiency leads to increased risk of severe infections, numerous diseases and pathological conditions, including disorders of vision, bones, epithelial tissue and immunity. It remains one of the main causes of preventable blindness in children. Nonetheless, excessive intake of vitamin A can also cause serious health problems. Objective. The aim of this study is to describe and summarize current knowledge about the role of vitamin A in the human organism, as well as to provide general information on its supplementation. State of Knowledge. Vitamin A is a group of similar organic compounds that cannot be synthesized in the human body, and therefore has to be included in the diet. Vitamin A influences the human body since foetal life. Both deficiency and an excess of vitamin A may cause serious complications. The main sources of the vitamin are meat, fish, poultry and dairy products. Its precursors, such as carotenoids, are present in fruit and vegetables. It is stored mainly in the liver and adipose tissue. Vitamin A has antioxidative attributes. Conclusion. An adequate intake of vitamin A is crucial for maintaining health and well-being, and deficiency as well as overdose of this vitamin may cause serious complications and diseases. [ABSTRACT FROM AUTHOR]

Abstract Vitamin A (retinol) is involved in signaling pathways regulating gene expression and was postulated to be a major antioxidant and anti-inflammatory compound of the diet. Parkinson's disease (PD) is a progressive neurodegenerative disorder, characterized by loss of nigral dopaminergic neurons, involving oxidative stress and pro-inflammatory activation. The aim of the present study was to evaluate the neuroprotective effects of retinol oral supplementation against 6-hydroxydopamine (6-OHDA, 12 μg per rat) nigrostriatal dopaminergic denervation in Wistar rats. Animals supplemented with retinol (retinyl palmitate, 3000 IU/kg/day) during 28 days exhibited increased retinol content in liver, although circulating retinol levels (serum) were unaltered. Retinol supplementation did not protect against the loss of dopaminergic neurons (assessed through tyrosine hydroxylase immunofluorescence and Western blot). Retinol supplementation prevented the effect of 6-OHDA on Iba-1 levels but had no effect on 6-OHDA-induced GFAP increase. Moreover, GFAP levels were increased by retinol supplementation alone. Rats pre-treated with retinol did not present oxidative damage or thiol redox modifications in liver, and the circulating levels of TNF-α, IL-1β, IL-6 and IL-10 were unaltered by retinol supplementation, demonstrating that the protocol used here did not cause systemic toxicity to animals. Our results indicate that oral retinol supplementation is not able to protect against 6-OHDA-induced dopaminergic denervation, and it may actually stimulate astrocyte reactivity without altering parameters of systemic toxicity. Highlights • Retinol oral supplementation does not cause systemic toxicity. • Retinol prevents 6-OHDA increase in serum TNF-α and IL-1β. • Retinol does not protect against 6-OHDA dopaminergic denervation. • Retinol changes astrocytes and microglia phenotype in substantia nigra. • Retinol prevents 6-OHDA-induced increase in Iba-1. [ABSTRACT FROM AUTHOR]

Background: Acne is a debilitating disorder that requires proper treatment depending on the clinical manifestations and pathogenetic factors, among which hyper-keratinization, seborrhea and bacterial proliferation. Combining active ingredients targeting the different mediators of acne pathogenesis may yield optimal outcomes. Purpose: The purpose of this study was to evaluate the clinical effectiveness, safety and tolerability of a new topical medical device in cream containing benzoylperoxide 4%, pure retinol 0.05%, palmitate retinol 0.5%, mandelic acid 1% and glycyrrhetic acid on patients with mild acne. Patients and methods: Twenty consecutive patients of both sexes with mild acne were included in the study. The topical treatment was self-applied twice a day for 12 weeks. Evaluations included: Global Acne Grading System (GAGS); inflammatory and non-inflammatory lesions count; reflectance confocal microscopy; seborrhea and hydration degree; photographic documentation; a questionnaire to assess tolerability. Results: The GAGS score showed a 39% reduction from T0 to T1 and 69.20% from T0 to T2. The count of comedonic lesions showed a 44% reduction from T0 to T1 and 65% from T0 to T2. The count of papular lesions diminished by 49.4% from T0 to T1 and by 62% from T0 to T2. The count of pustular lesions decreased by 43% from T0 to T1 and by 80% from T0 to T2. Improvement of hydration and a decrease of seborrhea degree were even observed. These clinical results were confirmed by reflectance confocal microscopy exam. Conclusion: The topical medical device has shown to be clinically effective and well tolerated for the treatment of mild acne. Side effects were mild, transient and well tolerated. The results of our study demonstrated a high tolerability of this new combination of benzoylperoxide 4% and retinol. Furthermore, our results suggested that the studied compound could be considered as a "maintenance treatment" after specific pharmacological treatment, even in more severe types of acne. [ABSTRACT FROM AUTHOR]

Background: Because of long-term exposure of skin, skin aging is an unavoidable natural law with age. Traditional Vitamin A and novel ablative fractional laser technique both have the effects of skin rejuvenation, and studies have demonstrated both of them have apparent clinical efficacy and histology-improving effects on photo-aging skin. Materials and methods: 45 female healthy Wistar rats were selected and the depilation areas of every rat were divided into four regions: control region(Region A), Vitamin A acid region(Region B), combination treatment region(Region C), and fractional laser region(Region D). 0.025% Vitamin A acid cream was applied to Region B and C every day for 3 weeks; Region C and D were irradiated once with 10600nm CO2 fractional laser on the first day of the trail. The skin tissue was dissected and placed into liquid nitrogen according to the design. The real-time quantitative PCR and western blotting methods were taken to detect the expression changes of miR-29a, Akt, TGF-β, and mRNA of type III pre-collagen. Results: It can be seen from the results of the real-time quantitative PCR that the mRNA expression levels of type III pre-collagen, Akt, and TGF-β in the treatment regions are up-regulated and the expression levels of miR-29a mRNA are down-regulated compared to the Region A. The hybridization tests showed that changes of the expression of type III pre-collagen, Akt gene, miR-29a gene, and TGF-β gene across the experiment regions are all significantly different in the third week, and the expression levels of them all achieve the highest value in the third week, the expression level of miR-29a gene achieves the lowest value in the third week, which are consistent with the results of real-time quantitative PCR. Conclusion: It is indicated that the combination region of Vitamin A acid and fractional laser may lead to low expression of miR-29a, thus the inhibition of downstream Akt activation is loss, Akt activation is enhanced, enhancement of the expression of TGF-β is induced, leading to proliferation of fibroblasts, and promotion of the collagen proteins' synthesis in skin. Therefore miR-29a/Akt/TGF-β signal pathway may participate in the skin rejuvenation mechanism of action Vitamin A acid and fractional laser. This may provide a new treatment approach for skin rejuvenation. [ABSTRACT FROM AUTHOR]